Healthcare Provider Details
I. General information
NPI: 1992052658
Provider Name (Legal Business Name): SWAPNIL KHURANA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/12/2012
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4546 EL CAMINO REAL STE B7
LOS ALTOS CA
94022-1069
US
IV. Provider business mailing address
4546 EL CAMINO REAL STE B7
LOS ALTOS CA
94022-1069
US
V. Phone/Fax
- Phone: 866-362-4246
- Fax: 650-260-6030
- Phone: 866-362-4246
- Fax: 650-260-6030
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | C193025 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 35129305 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0015X |
| Taxonomy | Psychosomatic Medicine Physician |
| License Number | C193025 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: